Osteocutaneous Radial Research Articles

Use of the Osteocutaneous Radial Epiphyseal Flap for Bone Reconstruction of the Hand

Since its first description in 1989, the use of the osteocutaneous radial epiphyseal flap has not been widely used. Fifteen island and free flaps were presented, among which 13 were in male patients, and 2 in female patients. The patient average age was 38 years (27 to 42 years). In 9 of the cases, the flap was used as a free flap, vascularized by the anterior interosseous artery. In the other 6 cases, a distally–based island flap was used. Eight of the15 flaps were osteocutaneous. The main indication was a bone reconstruction at the wrist, the thumb, and long fingers and in on of the cases, a nerve reconstruction.

A Novel Technique for the Prophylactic Plating of the Osteocutaneous Radial Forearm Flap Donor Site

The osteocutaneous radial forearm free flap (ORFFF) provides a suitable composite construct for reconstruction of head and neck defects. Initial acceptance of the ORFFF during the 1980s waned significantly as long-term outcome studies demonstrated a high incidence of donor-site fractures associated with harvesting a segment of the cortical radius. Biomechanical and clinical studies have demonstrated a significant improvement in the mechanical strength of ostectomized long bones after prophylactic plating. Our case report identifies a novel technique for rigid fixation using a low-contact, locking-screw plating system (LCP, Synthes USA). The system provides a fixed-angle construct using a locking-screw system that provides appropriate axial load transfer using unicortical screw fixation.

The Role of the Osteocutaneous Radial Forearm Free Flap in the Treatment of Mandibular Osteoradionecrosis

To evaluate the role of the osteocutaneous radial forearm free flap (OCRFFF) in the treatment of mandibular osteoradionecrosis (ORN). Retrospective case review of patients who underwent OCRFFF oromandibular reconstruction after resection of nonviable tissue at an academic tertiary care center because of ORN. Patients with reconstructions other than OCRFFF were excluded from this study. Nine patients underwent a composite oromandibular resection for ORN with a reconstruction using an OCRFFF between April 1998 and February 2003. All patients had failed previous less aggressive surgical and medical management of the ORN. Mean follow-up was 36 months (range, 14-67 months). There were no flap failures or significant immediate postoperative or long-term complications observed. All patients had successful restoration of mandibular integrity and continuity, with 100% success rate of stabilization of ORN. All patients were able to tolerate PO diet, with only one third having to supplement their diet with gastrostomy feedings, compared with 89% gastrostomy dependence preoperatively. Primary or adjuvant radiotherapy for head and neck malignancies can result in ORN of the mandible. This difficult problem often requires surgical intervention. In our experience, the OCRFFF can be successfully used for oromandibular reconstruction, even in the setting of the heavily radiated tissue with excellent postoperative outcomes. This is the first study that demonstrates the efficacy of the OCRFFF as a treatment of mandibular ORN.

One Stage Reconstruction of Intercalated Defect of the Thumb Using the Osteocutaneous Radial Forearm Flap

A radial forearm flap including a segment of the cortex of the radius, based on the distal pedicle of the radial vessels and the cephalic vein, was used to reconstruct an intercalated defect of the thumb in two cases. In one case it was used as an ipsilateral pedicle flap while in the other case it was used as a free microvascular flap. In both cases, the skin flap as well as the segment of bone survived in toto without any evidence of creeping substitution. The functional result was good in both cases. This flap provides thin skin of good texture together with bone for a one-stage reconstruction.

The osteocutaneous pedicle forearm flap

Two patients treated by an osteocutaneous radial island flap with retrograde blood flow are described. Rotation of the flap and its distal vascular pedicle by nearly 180 degrees caused no impairment of the arterial flow, but it may interfere with the venous return through the radial veins, as observed in one of our cases. Therefore, it is safer to include in the skin flap an additional vein, suturing it to a superficial vein in the recipient zone, thus ensuring normal venous flow to the flap as well. The purpose of this paper is to present two patients treated by the use of an osteocutaneous radial artery forearm flap.

The Osteocutaneous Pedicle Forearm Flap

Two patients treated by an osteocutaneous radial island flap with retrograde blood flow are described. Rotation of the flap and its distal vascular pedicle by nearly 180 degrees caused no impairment of the arterial flow, but it may interfere with the venous return through the radial veins, as observed in one of our cases. Therefore, it is safer to include in the skin flap an additional vein, suturing it to a superficial vein in the recipient zone, thus ensuring normal venous flow to the flap as well. The purpose of this paper is to present two patients treated by the use of an osteocutaneous radial artery forearm flap.